Monday, April 23, 2018

2018 Residency Match Update

The National Resident Matching Program Advance Data Tables for the 2018 Main Residency Match again show an increase in the number of first-year positions offered, going from 28,849 in 2017 to 30,232 this year.

Of the 18,818 seniors graduating from US allopathic medical schools, 17,740 (94.3%) matched, 1078 (5.7%) did not match, and 474 withdrew or did not submit a rank list. The 5.7% who went unmatched was identical to last year’s figure.

The 1511 graduates of US allopathic medical schools from previous years did not fare as well with 43.8% matching and 56.2% going unmatched—slightly worse than the 2017 percentages.

Wednesday, April 18, 2018

What is the worst way to combat school shootings?


Please read carefully because there might be a test.

A school district in Pennsylvania placed a 5 gallon bucket of rocks in each classroom two years ago. If locking and barricading the classroom door does not work, the students have been instructed to throw rocks at the would-be shooter instead of hiding under their desks.

According to a Buzzfeed story, the school superintendent for Schuylkill County believes the rocks serve as a powerful deterrent. He said, “If an armed intruder attempts to gain entrance to any of our classrooms, they will face a classroom full of students armed with rocks. And they will be stoned.”

Maybe it’s working. Since the arrival of the rocks, there have been no shooter incidents in any Schuylkill County school.

Wednesday, April 4, 2018

The decline and fall of the rectal exam



For almost 20 years, the value of the digital rectal exam (DRE), a long time staple of the complete examination of the trauma patient, has been questioned. Performing a rectal examination on all trauma patients is no longer advocated except for a few specific indications.

As recently as two months ago, trauma surgeon Michael McGonigal blogging at The Trauma Pro reinforced the message. Because a rectal examination is so uncomfortable for patients already traumatized and its yield is so minimal, he advocates doing it in only patients with spinal cord injury, pelvic fracture, and penetrating abdominal trauma. For a more extensive discussion of the topic, see Life in the Fastlane, an emergency medicine blog.